Ishani Bora - Academia.edu (original) (raw)

Papers by Ishani Bora

Research paper thumbnail of Biomedical Waste Management during COVID-19 Pandemic: A Medical Institute Perspective

International Journal of Health Sciences and Research, Feb 11, 2023

Research paper thumbnail of Dengue outbreaks in South Asia amid Covid-19: Epidemiology, transmission, and mitigation strategies

Frontiers in Public Health, Dec 15, 2022

Research paper thumbnail of Multiple Rift Valley Fever outbreaks in Uganda: Should there be global concern?

Journal of Infection and Public Health

Research paper thumbnail of Avian influenza revisited: concerns and constraints

Research paper thumbnail of P313 A retrospective analysis of COVID-19 - associated Mucormycosis in a tertiary care center in Northern India

Medical Mycology

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Methods This is a retrospec... more Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Methods This is a retrospective observational study with (n = 433) samples. Nasopharyngeal and oropharyngeal swabs were collected from clinically suspected cases of mucormycosis. These were then subjected to Xpert® Xpress SARS-CoV-2 test. Those samples which tested positive were included in this study. A history sheet form was designed and filled up for 238 patients who were admitted and could be traced properly. Results Total number of SARS CoV-2 positive samples was 296 out of 433 samples. Among the tested 66% (287/433) were male and 34% (146/433) were female. Relative positivity was higher among women 74% (107/144) than men 66% (189/285). Amongst 238 admitted patients, 83.1% patients (198/238) completed treatment and were discharged while 13.9% (33/238) succumbed during management. Diabetes was found to be most common risk factor at 88.65% (211/238) followed by hypertension 36.5% (87/238), and corticosteroid us...

Research paper thumbnail of Hydroxychloroquine in Treatment of Asymptomatic and Mildly Symptomatic COVID-19: A Multi-Centre Cohort Study

Journal of Association of Physicians of India, 2022

Although hydroxychloroquine (HCQ) lacks benefit in patients with moderate-to-severe COVID-19, its... more Although hydroxychloroquine (HCQ) lacks benefit in patients with moderate-to-severe COVID-19, its role in asymptomatic and mildly symptomatic disease needs better elucidation. This multi-centre cohort study included asymptomatic and mildly symptomatic, RT-PCR confirmed COVID-19 cases between 30 March and 20 May, 2020. Patients were categorized into two groups (HCQ-treated and untreated) based on exposure to HCQ. Dose of HCQ used was 400 mg twice daily (day one) followed by once daily for seven days. HCQ-untreated patients were managed supportively without any active antiviral or immunomodulatory therapy. Nasopharyngeal SARS-CoV-2 clearance by RT-PCR (primary outcome) was compared between HCQ-treated and untreated patients using Kaplan-Meier analysis and Cox proportional-hazards regression. Clinical efficacy and safety profile of HCQ were assessed (secondary outcomes). 162 patients [84 (51·9%) males; mean age 38·2 (15·2) years] were included. Forty-four (27·2%) patients had mild disease, rest 118 (72·8%) were asymptomatic. Seventy-five (46·3%) patients received HCQ. Median time to virological negativity was lesser in HCQ-treated (13 days) versus untreated patients (15 days) (logrank<0·001) in both asymptomatic and mildly symptomatic patients. Treatment with HCQ was the only independent predictor of virological negativity (hazardratio=2·24; adjusted p-value<0·001). Two (5·4%) mildly symptomatic patients progressed to severe disease within 24 hours (two doses) of HCQ initiation, compared to none in the HCQ-untreated group. Five HCQ-treated patients developed minor gastrointestinal side effects, not requiring drug discontinuation. HCQ reduced the time to virologic negativity (by 2 days) in asymptomatic and mildly symptomatic COVID-19, without any serious adverse events. However, no obvious clinical benefit was noted.

Research paper thumbnail of Indira Gandhi Regional Institute of Health and Medical Sciences

Objective of this study is to know the incidence of biofilm formation by Candida spp among the in... more Objective of this study is to know the incidence of biofilm formation by Candida spp among the intensive care unit patients and to identify the relationship between various Candida species with their antifungal susceptibility at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Materials and Methods: A prospective study conducted at NEIGRIHMS, among patients admitted to the ICU during the period between January 1 st and December 31 st 2015. Different samples like endotracheal secretion, urine, blood and pus were collected under sterile conditions and standard fungal tests were performed for identification and appropriate statistical methods were employed to look for association between biofilm and Candida species. Results: Out of the 396 samples included in the study from ICU, 117 samples showed evidence of Candida infections yielding an infection rate of 29.5%. Among the 189 isolates (63 Candida albicans and 126 Non albicans Candid...

Research paper thumbnail of Bacteriological Profile of Pleural Fluid among the Pediatric Population In A Tertiary Care Centre - A Retrospective Analysis

International Journal of Health Sciences and Research, 2015

Background and Objectives: Pleural effusion, mainly of infectious etiology, is one of the major c... more Background and Objectives: Pleural effusion, mainly of infectious etiology, is one of the major causes of morbidity among children. There is a trend in changing etiology which also varies with several clinical factors. This study was undertaken to determine the bacteriological profile of pleural fluid from children diagnosed with pleural effusion in a Tertiary Care Centre in the North East of India. Materials and Methods: Pleural fluid collected from children diagnosed with pleural effusion between January 2011 and December 2012, were subjected to standard aerobic bacteriological culture for isolation, identification and antimicrobial susceptibility of the etiological agent(s). Results: Of the 134 samples received, 50 samples had an identifiable etiology with 2 patients having a mixed infection. The organism isolated were Streptococcus pneumonia (54%) followed by Staphylococcus aureus (16%), Klebsiella pneumonia (8%), Pseudomonas aeruginosa and Escherichia coli (6%) and Candida spec...

Research paper thumbnail of Prevalence of non-albicans candidemia in a tertiary care hospital in Northeast India

International Journal of Medical Science and Public Health, 2017

Bloodstream infections (BSI) caused by various Candida species have been reported from many count... more Bloodstream infections (BSI) caused by various Candida species have been reported from many countries worldwide and are a significant cause of morbidity and mortality in hospitalized patients. Candidemia has been associated with many risk factors such as long-term hospitalization, antibiotic therapy, use of intravascular catheters, and underlying diseases

Research paper thumbnail of Clinico demographic profiling of the Respiratory syncytial virus (RSV) infected children admitted in tertiary care hospital in North India

Journal of Family Medicine and Primary Care, 2021

Background: Acute bronchiolitis is fatal disease involving lower respiratory tract of infants and... more Background: Acute bronchiolitis is fatal disease involving lower respiratory tract of infants and children of paediatric age group. Respiratory Syncytial Virus (RSV) is responsible for causing more than 70% hospital admissions of children aged less than 2 years thus making a necessity for accurate and timely diagnosis. Aims: The main aim of study was clinicodemographic correlation of RSV positive children presenting to our tertiary care hospital. Setting and Design: It is a retrospective study done between December to January 2018. Materials and Methods: Detection of RSV antigen from nasophyrangeal aspirates using Mouse Monoclonal anti RSV Antibody (by Novatetra) and Goat Anti Mouse Antibody conjugated with FITC as secondary antibody. Results: A total of 147 samples were received in the laboratory and 20 were tested as positive for RSV Antigen. Totally, 19/20 children were aged less than 1 year and with a male predominance. The most common symptom was cough and respiratory distress. Eight percent of the children showed wheezing and 18/20 required assisted ventilation. The clinical course in one child deteriorated leading to death of that patient. Conclusions: The timely diagnosis and management of RSV infected children is utmost needed to prevent morbidity and mortality. The premorbid conditions can assist to differentiate the viral from bacterial pneumonia and thus enable speedy recovery of the child.

Research paper thumbnail of Perplexity vs Clarity in choosing the right molecular diagnostic techniques for SARS-COV2 detection in Indian setup

Journal of Family Medicine and Primary Care, 2021

After the havoc created by Spanish flu a century ago, the world is witnessing exactly a similar p... more After the havoc created by Spanish flu a century ago, the world is witnessing exactly a similar pandemic situation since the beginning of the year 2020. The unexplained respiratory illness with high morbidity & mortality which started in Wuhan, China and spread across the world was finally termed as COVID-19 disease caused by SARS-CoV-2 and later announced as pandemic by WHO. This novel virus SARS-CoV-2 is a new variant of SARS corona virus with high infectivity and mysterious pathophysiology. The major step towards containment of this pandemic is to scale up the testing for SARS-CoV-2 and thereby isolating and managing the patients at the earliest. Molecular amplification based methods such a Real time Polymerase chain reaction (RT-PCR), CBNAAT and TrueNAT are the most commonly used techniques for detection of SARS-CoV2. To utilize these diagnostic facilities optimally in the management of the suspected COVID 19 patients, it is of utmost importance for the healthcare providers to understand the intricacies related to these technologies. Thus, the technical details along with the pros & cons of these three amplification-based technologies for proper understanding of these diagnostic modalities for SARS COV-2 diagnosis are discussed herewith.

Research paper thumbnail of Rapid antigen detection kit for the diagnosis of SARS-CoV-2 - are we missing asymptomatic patients?

Indian Journal of Medical Microbiology, 2021

Purpose To determine the utility, diagnostic accuracy, sensitivity, specificity, and negative pre... more Purpose To determine the utility, diagnostic accuracy, sensitivity, specificity, and negative predictive value of the laboratory based Covid-19 antigen detection test (Coris Bio- Concept, Gembloux, Belgium) for the diagnosis of SARS-CoV-2 in a tertiary care hospital among symptomatic and asymptomatic patients. Methods The nasopharyngeal swab samples were collected from the symptomatic patients and their contacts. The diagnostic accuracy of this antigen kit was determined in comparison to SARS-CoV-2 real-time reverse transcriptase (RT-PCR). Results A total of 825 patients fulfilling the inclusion criteria were included in the study; RT-PCR and antigen detection was performed simultaneously for 484 samples to determine the sensitivity and specificity of the test. The overall specificity and sensitivity was 99.32% and 71.96% respectively. Also, 3.7% of the asymptomatic patients who were negative by RAT were detected positive by RT-PCR. Conclusion This rapid antigen test (RAT) was sensitive in the symptomatic patients presenting during the initial phase of the illness. Since, majority of the SARS-CoV-2 patients are asymptomatic and considering the huge population, the testing strategy formulated by Indian Council of Medical Research (ICMR) at the national level was cost effective. Thus, Ag-RDTs could play a pivotal role in early diagnosis, policy making and surveillance of the SARS-CoV-2.

Research paper thumbnail of Clinico-virological Profile, Intensive Care Needs, and Outcome of Infants with Acute Viral Bronchiolitis: A Prospective Observational Study

Indian Journal of Critical Care Medicine, 2021

Objectives: The objective of the study was to describe the clinico-virological profile, treatment... more Objectives: The objective of the study was to describe the clinico-virological profile, treatment details, intensive care needs, and outcome of infants with acute viral bronchiolitis (AVB). Methodology: In this prospective observational study, 173 infants with AVB admitted to the pediatric emergency room and pediatric intensive care unit (PICU) of a tertiary care teaching hospital in North India during November 2019 to February 2020 were enrolled. The data collection included clinical features, viruses detected [respiratory syncytial virus (RSV), rhinovirus, influenza A virus, parainfluenza (PIV) 2 and 3, and human metapneumovirus (hMPV)], complications, intensive care needs, treatment, and outcomes. Multivariate analysis was performed to determine independent predictors for PICU admission. Results: Most common symptoms were rapid breathing (98.8%), cough (98.3%), and fever (74%). On examination, tachypnea (98.8%), chest retractions (93.6%), respiratory failure (84.4%), wheezing (49.7%), and crepitations (23.1%) were observed. RSV and rhinovirus were the predominant isolates. Complications were noted in 25% of cases as encephalopathy (17.3%), transaminitis (14.3%), shock (13.9%), acute kidney injury (AKI) (7.5%), myocarditis (6.4%), multiple organ dysfunction syndrome (MODS) (5.8%), and acute respiratory distress syndrome (ARDS) (4.6%). More than one-third of cases required PICU admission. The treatment details included nasal cannula oxygen (11%), continuous positive airway pressure (51.4%), high-flow nasal cannula (14.5%), mechanical ventilation (23.1%), nebulization (74%), antibiotics (35.9%), and vasoactive drugs (13.9%). The mortality was 8.1%. Underlying comorbidity, chest retractions, respiratory failure at admission, presence of shock, and need for mechanical ventilation were independent predictors of PICU admission. Isolation of virus or coinfection was not associated with disease severity, intensive care needs, and outcomes. Conclusion: Among infants with AVB, RSV and rhinovirus were predominant. One-third infants with AVB needed PICU admission. The presence of comorbidity, chest retractions, respiratory failure, shock, and need for mechanical ventilation independently predicted PICU admission.

Research paper thumbnail of Clinical Profile, Hospital Course and Outcome of Children with COVID-19

Indian Journal of Pediatrics, 2021

Objectives To describe the epidemiological and clinical characteristics and outcome of hospitaliz... more Objectives To describe the epidemiological and clinical characteristics and outcome of hospitalized children with COVID-19 during the initial phase of the pandemic. Methods This was a cross-sectional descriptive study conducted at the dedicated COVID-19 hospital of a tertiary care referral center in North India. Consecutive children aged 14 y or younger who tested positive for SARS-CoV-2 by RT-PCR from nasopharyngeal swab between 1 April 2020 and 15 July 2020 were included. Results Of 31 children with median (IQR) age of 33 (9-96) mo, 9 (29%) were infants. About 74% (n = 23) had history of household contact. Comorbidities were noted in 6 (19%) children. More than half (58%) were asymptomatic. Of 13 symptomatic children, median (IQR) duration of symptoms was 2 (1-5.5) d. Fever (32%) was most common followed by cough (19%), rapid breathing (13%), diarrhea (10%) and vomiting (10%). Severe [n = 4, 13%] and critical [n = 1, 3%] illnesses were noted more commonly in infants with comorbidities. Three (10%) children required PICU admission and invasive ventilation; one died. Median (IQR) length of hospital stay was 15 (11-20) d. Follow up RT-PCR before discharge was performed in 17 children and the median (IQR) duration to RT-PCR negativity was 16 (12-19) d. Conclusions In the early pandemic, most children with COVID-19 had a household contact and presented with asymptomatic or mild illness. Severe and critical illness were observed in young infants and those with comorbidities.

Research paper thumbnail of Multi-Organ Involvement in COVID-19: Beyond Pulmonary Manifestations

Journal of Clinical Medicine, 2021

Coronavirus Disease 19 (COVID-19), due to severe acute respiratory syndrome coronavirus-2 (SARS-C... more Coronavirus Disease 19 (COVID-19), due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become an on-going global health emergency affecting over 94 million cases with more than 2 million deaths globally. Primarily identified as atypical pneumonia, it has developed into severe acute respiratory distress syndrome (ARDS), a multi-organ dysfunction with associated fatality. Ever since its emergence, COVID-19 with its plethora of clinical presentations has signalled its dynamic nature and versatility of the disease process. Being a disease with droplet transmission has now assumed the proportion of a suspected airborne nature which, once proved, poses a Herculean task to control. Because of the wide distribution of the human angiotensin-converting enzyme-2 (hACE2) receptors, known for its transmission, we envisage its multiorgan spread and extensive disease distribution. Thus, an extensive review of the extrapulmonary organotropism of SARS-CoV-2 with organ-specific pa...

Research paper thumbnail of Pathological Involvement of Cardiovascular System in COVID-19: A Systematic Review

Research paper thumbnail of Persistence of SARS-COV-2 in body fluids: a bystander or whistle blower

Iranian Journal of Microbiology, 2020

The novel Coronavirus COVID-19 is wrecking a havoc across the globe and has been declared as a pa... more The novel Coronavirus COVID-19 is wrecking a havoc across the globe and has been declared as a pandemic by WHO. Apart from transmission and shedding of the virus through respiratory secretions in the form of droplets (mainly), several studies have shown the presence of the virus in various samples such as stool, urine and occasionally in blood, semen, tears and breastmilk. Whereas government authority guidelines consider a person as cured from COVID-19 when along with clinical improvement no more virus can be detected primarily on respiratory samples along with clinical improvement; the persistence of the virus in these body fluids even after clinical recovery and negative RT-PCR test results on respiratory samples, has raised many questions about the elusive nature of this novel virus along with the possibility of other routes of transmission of this virus in the community. Although studies performed till now across the globe on persistence of SARSCOV-2 in various body fluids are s...

Research paper thumbnail of Viral Hepatitis E and Chronicity: A Growing Public Health Concern

Frontiers in Microbiology, 2020

Hepatitis E viral infection recently emerges as a global health concern. Over the last decade, th... more Hepatitis E viral infection recently emerges as a global health concern. Over the last decade, the understanding of hepatitis E virus (HEV) had changed with the discovery of new genotypes like genotype-7 and genotype-8 with associated host and mode of infection. Diversification in the mode of hepatitis E infection transmission through blood transfusion, and organ transplants in contrast to classical feco-oral and zoonotic mode is the recent medical concern. The wide spectrum of infection ranging from selflimiting to acute liver failure is now overpowered by HEV genotype-specific chronic infection especially in transplant patients. This concern is further escalated by the extrahepatic manifestations of HEV targeting the central nervous system (CNS), kidney, heart, and pancreas. However, with the development of advanced efficient cell culture systems and animal models simulating the infection, much clarity toward understanding the pathogenetic mechanism of HEV has been developed. Also this facilitates the development of vaccines research or therapeutics. In this review, we highlight all the novel findings in every aspect of HEV with special emphasis on recently emerging chronic mode of infection with specific diagnosis and treatment regime with an optimistic hope to help virologists and/or liver specialists working in the field of viral hepatitis.

Research paper thumbnail of Antimicrobial Activity of Aristolochia tagala Cham. Centella asiatica Linn. Houttuynia cordata Thunb. on Multi- drug Resistant Clinical Isolates

International Journal of Pharmaceutical Sciences Review and Research, 2020

The objective of this study is to evaluation of antimicrobial activity of Aristolochia tagala Cha... more The objective of this study is to evaluation of antimicrobial activity of Aristolochia tagala Cham. (AT), Centella asiatica Linn. (CA), Houttuynia cordata Thunb (HC) on multi-drug resistant bacteria isolated from clinical samples. Alcoholic extracts of these plants carried out by adopting Kirby-Bauer disc diffusion method against standard strains (ATCC) and resistant clinical isolates of Staphyllococcus aureus, Enterococcus faecalis and Staphyllococcus aureus. Piperacillin, ampicillin, amikacin, ciprofloxacin, and cefotaxime served as positive controls in the standard test and nitrofurantoin, teicoplanin, linezolid, and vancomycin were used in the testing of the resistant isolates. 100 mg/mL of the plant extracts were used as the test extracts taking 2.5 % DMSO as a negative control. From the zone of inhibition (mm) recorded, AT demonstrated higher antimicrobial efficacy against Enterococcus and S. aureus. Another significant finding is HC showed considerable effectiveness against E.Coli. However, methanolic extract of CA showed only moderate antimicrobial activity. Good antibacterial activity was seen with AT alcoholic extracts for Enterococcus and S. aureus resistant strains in clinical isolates. Antibacterial activity of HC against E. coli isolates also holds promising results.

Research paper thumbnail of An anatomical model for SARS-CoV-2 entry into mastoid and middle ear in COVID-19 patients

Recently Frazier et al detected SARS-CoV-2 virus in autopsy samples from middle ear and mastoid o... more Recently Frazier et al detected SARS-CoV-2 virus in autopsy samples from middle ear and mastoid of COVID-19 deceased. Our article presents an anatomical model for the possible route by which SARS-CoV-2 may pass into the middle ear cavity and hence to the mastoid cavity. The anatomic correlation explained in this article will not only help in explaining the pathological basis of the findings presented by Frazier et al but will also imply for the precautionary measures to be taken while dealing with COVID-19 patients with otolaryngeal problems.

Research paper thumbnail of Biomedical Waste Management during COVID-19 Pandemic: A Medical Institute Perspective

International Journal of Health Sciences and Research, Feb 11, 2023

Research paper thumbnail of Dengue outbreaks in South Asia amid Covid-19: Epidemiology, transmission, and mitigation strategies

Frontiers in Public Health, Dec 15, 2022

Research paper thumbnail of Multiple Rift Valley Fever outbreaks in Uganda: Should there be global concern?

Journal of Infection and Public Health

Research paper thumbnail of Avian influenza revisited: concerns and constraints

Research paper thumbnail of P313 A retrospective analysis of COVID-19 - associated Mucormycosis in a tertiary care center in Northern India

Medical Mycology

Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Methods This is a retrospec... more Poster session 2, September 22, 2022, 12:30 PM - 1:30 PM Objectives Methods This is a retrospective observational study with (n = 433) samples. Nasopharyngeal and oropharyngeal swabs were collected from clinically suspected cases of mucormycosis. These were then subjected to Xpert® Xpress SARS-CoV-2 test. Those samples which tested positive were included in this study. A history sheet form was designed and filled up for 238 patients who were admitted and could be traced properly. Results Total number of SARS CoV-2 positive samples was 296 out of 433 samples. Among the tested 66% (287/433) were male and 34% (146/433) were female. Relative positivity was higher among women 74% (107/144) than men 66% (189/285). Amongst 238 admitted patients, 83.1% patients (198/238) completed treatment and were discharged while 13.9% (33/238) succumbed during management. Diabetes was found to be most common risk factor at 88.65% (211/238) followed by hypertension 36.5% (87/238), and corticosteroid us...

Research paper thumbnail of Hydroxychloroquine in Treatment of Asymptomatic and Mildly Symptomatic COVID-19: A Multi-Centre Cohort Study

Journal of Association of Physicians of India, 2022

Although hydroxychloroquine (HCQ) lacks benefit in patients with moderate-to-severe COVID-19, its... more Although hydroxychloroquine (HCQ) lacks benefit in patients with moderate-to-severe COVID-19, its role in asymptomatic and mildly symptomatic disease needs better elucidation. This multi-centre cohort study included asymptomatic and mildly symptomatic, RT-PCR confirmed COVID-19 cases between 30 March and 20 May, 2020. Patients were categorized into two groups (HCQ-treated and untreated) based on exposure to HCQ. Dose of HCQ used was 400 mg twice daily (day one) followed by once daily for seven days. HCQ-untreated patients were managed supportively without any active antiviral or immunomodulatory therapy. Nasopharyngeal SARS-CoV-2 clearance by RT-PCR (primary outcome) was compared between HCQ-treated and untreated patients using Kaplan-Meier analysis and Cox proportional-hazards regression. Clinical efficacy and safety profile of HCQ were assessed (secondary outcomes). 162 patients [84 (51·9%) males; mean age 38·2 (15·2) years] were included. Forty-four (27·2%) patients had mild disease, rest 118 (72·8%) were asymptomatic. Seventy-five (46·3%) patients received HCQ. Median time to virological negativity was lesser in HCQ-treated (13 days) versus untreated patients (15 days) (logrank<0·001) in both asymptomatic and mildly symptomatic patients. Treatment with HCQ was the only independent predictor of virological negativity (hazardratio=2·24; adjusted p-value<0·001). Two (5·4%) mildly symptomatic patients progressed to severe disease within 24 hours (two doses) of HCQ initiation, compared to none in the HCQ-untreated group. Five HCQ-treated patients developed minor gastrointestinal side effects, not requiring drug discontinuation. HCQ reduced the time to virologic negativity (by 2 days) in asymptomatic and mildly symptomatic COVID-19, without any serious adverse events. However, no obvious clinical benefit was noted.

Research paper thumbnail of Indira Gandhi Regional Institute of Health and Medical Sciences

Objective of this study is to know the incidence of biofilm formation by Candida spp among the in... more Objective of this study is to know the incidence of biofilm formation by Candida spp among the intensive care unit patients and to identify the relationship between various Candida species with their antifungal susceptibility at North Eastern Indira Gandhi Regional Institute of Health and Medical Sciences (NEIGRIHMS), Shillong. Materials and Methods: A prospective study conducted at NEIGRIHMS, among patients admitted to the ICU during the period between January 1 st and December 31 st 2015. Different samples like endotracheal secretion, urine, blood and pus were collected under sterile conditions and standard fungal tests were performed for identification and appropriate statistical methods were employed to look for association between biofilm and Candida species. Results: Out of the 396 samples included in the study from ICU, 117 samples showed evidence of Candida infections yielding an infection rate of 29.5%. Among the 189 isolates (63 Candida albicans and 126 Non albicans Candid...

Research paper thumbnail of Bacteriological Profile of Pleural Fluid among the Pediatric Population In A Tertiary Care Centre - A Retrospective Analysis

International Journal of Health Sciences and Research, 2015

Background and Objectives: Pleural effusion, mainly of infectious etiology, is one of the major c... more Background and Objectives: Pleural effusion, mainly of infectious etiology, is one of the major causes of morbidity among children. There is a trend in changing etiology which also varies with several clinical factors. This study was undertaken to determine the bacteriological profile of pleural fluid from children diagnosed with pleural effusion in a Tertiary Care Centre in the North East of India. Materials and Methods: Pleural fluid collected from children diagnosed with pleural effusion between January 2011 and December 2012, were subjected to standard aerobic bacteriological culture for isolation, identification and antimicrobial susceptibility of the etiological agent(s). Results: Of the 134 samples received, 50 samples had an identifiable etiology with 2 patients having a mixed infection. The organism isolated were Streptococcus pneumonia (54%) followed by Staphylococcus aureus (16%), Klebsiella pneumonia (8%), Pseudomonas aeruginosa and Escherichia coli (6%) and Candida spec...

Research paper thumbnail of Prevalence of non-albicans candidemia in a tertiary care hospital in Northeast India

International Journal of Medical Science and Public Health, 2017

Bloodstream infections (BSI) caused by various Candida species have been reported from many count... more Bloodstream infections (BSI) caused by various Candida species have been reported from many countries worldwide and are a significant cause of morbidity and mortality in hospitalized patients. Candidemia has been associated with many risk factors such as long-term hospitalization, antibiotic therapy, use of intravascular catheters, and underlying diseases

Research paper thumbnail of Clinico demographic profiling of the Respiratory syncytial virus (RSV) infected children admitted in tertiary care hospital in North India

Journal of Family Medicine and Primary Care, 2021

Background: Acute bronchiolitis is fatal disease involving lower respiratory tract of infants and... more Background: Acute bronchiolitis is fatal disease involving lower respiratory tract of infants and children of paediatric age group. Respiratory Syncytial Virus (RSV) is responsible for causing more than 70% hospital admissions of children aged less than 2 years thus making a necessity for accurate and timely diagnosis. Aims: The main aim of study was clinicodemographic correlation of RSV positive children presenting to our tertiary care hospital. Setting and Design: It is a retrospective study done between December to January 2018. Materials and Methods: Detection of RSV antigen from nasophyrangeal aspirates using Mouse Monoclonal anti RSV Antibody (by Novatetra) and Goat Anti Mouse Antibody conjugated with FITC as secondary antibody. Results: A total of 147 samples were received in the laboratory and 20 were tested as positive for RSV Antigen. Totally, 19/20 children were aged less than 1 year and with a male predominance. The most common symptom was cough and respiratory distress. Eight percent of the children showed wheezing and 18/20 required assisted ventilation. The clinical course in one child deteriorated leading to death of that patient. Conclusions: The timely diagnosis and management of RSV infected children is utmost needed to prevent morbidity and mortality. The premorbid conditions can assist to differentiate the viral from bacterial pneumonia and thus enable speedy recovery of the child.

Research paper thumbnail of Perplexity vs Clarity in choosing the right molecular diagnostic techniques for SARS-COV2 detection in Indian setup

Journal of Family Medicine and Primary Care, 2021

After the havoc created by Spanish flu a century ago, the world is witnessing exactly a similar p... more After the havoc created by Spanish flu a century ago, the world is witnessing exactly a similar pandemic situation since the beginning of the year 2020. The unexplained respiratory illness with high morbidity & mortality which started in Wuhan, China and spread across the world was finally termed as COVID-19 disease caused by SARS-CoV-2 and later announced as pandemic by WHO. This novel virus SARS-CoV-2 is a new variant of SARS corona virus with high infectivity and mysterious pathophysiology. The major step towards containment of this pandemic is to scale up the testing for SARS-CoV-2 and thereby isolating and managing the patients at the earliest. Molecular amplification based methods such a Real time Polymerase chain reaction (RT-PCR), CBNAAT and TrueNAT are the most commonly used techniques for detection of SARS-CoV2. To utilize these diagnostic facilities optimally in the management of the suspected COVID 19 patients, it is of utmost importance for the healthcare providers to understand the intricacies related to these technologies. Thus, the technical details along with the pros & cons of these three amplification-based technologies for proper understanding of these diagnostic modalities for SARS COV-2 diagnosis are discussed herewith.

Research paper thumbnail of Rapid antigen detection kit for the diagnosis of SARS-CoV-2 - are we missing asymptomatic patients?

Indian Journal of Medical Microbiology, 2021

Purpose To determine the utility, diagnostic accuracy, sensitivity, specificity, and negative pre... more Purpose To determine the utility, diagnostic accuracy, sensitivity, specificity, and negative predictive value of the laboratory based Covid-19 antigen detection test (Coris Bio- Concept, Gembloux, Belgium) for the diagnosis of SARS-CoV-2 in a tertiary care hospital among symptomatic and asymptomatic patients. Methods The nasopharyngeal swab samples were collected from the symptomatic patients and their contacts. The diagnostic accuracy of this antigen kit was determined in comparison to SARS-CoV-2 real-time reverse transcriptase (RT-PCR). Results A total of 825 patients fulfilling the inclusion criteria were included in the study; RT-PCR and antigen detection was performed simultaneously for 484 samples to determine the sensitivity and specificity of the test. The overall specificity and sensitivity was 99.32% and 71.96% respectively. Also, 3.7% of the asymptomatic patients who were negative by RAT were detected positive by RT-PCR. Conclusion This rapid antigen test (RAT) was sensitive in the symptomatic patients presenting during the initial phase of the illness. Since, majority of the SARS-CoV-2 patients are asymptomatic and considering the huge population, the testing strategy formulated by Indian Council of Medical Research (ICMR) at the national level was cost effective. Thus, Ag-RDTs could play a pivotal role in early diagnosis, policy making and surveillance of the SARS-CoV-2.

Research paper thumbnail of Clinico-virological Profile, Intensive Care Needs, and Outcome of Infants with Acute Viral Bronchiolitis: A Prospective Observational Study

Indian Journal of Critical Care Medicine, 2021

Objectives: The objective of the study was to describe the clinico-virological profile, treatment... more Objectives: The objective of the study was to describe the clinico-virological profile, treatment details, intensive care needs, and outcome of infants with acute viral bronchiolitis (AVB). Methodology: In this prospective observational study, 173 infants with AVB admitted to the pediatric emergency room and pediatric intensive care unit (PICU) of a tertiary care teaching hospital in North India during November 2019 to February 2020 were enrolled. The data collection included clinical features, viruses detected [respiratory syncytial virus (RSV), rhinovirus, influenza A virus, parainfluenza (PIV) 2 and 3, and human metapneumovirus (hMPV)], complications, intensive care needs, treatment, and outcomes. Multivariate analysis was performed to determine independent predictors for PICU admission. Results: Most common symptoms were rapid breathing (98.8%), cough (98.3%), and fever (74%). On examination, tachypnea (98.8%), chest retractions (93.6%), respiratory failure (84.4%), wheezing (49.7%), and crepitations (23.1%) were observed. RSV and rhinovirus were the predominant isolates. Complications were noted in 25% of cases as encephalopathy (17.3%), transaminitis (14.3%), shock (13.9%), acute kidney injury (AKI) (7.5%), myocarditis (6.4%), multiple organ dysfunction syndrome (MODS) (5.8%), and acute respiratory distress syndrome (ARDS) (4.6%). More than one-third of cases required PICU admission. The treatment details included nasal cannula oxygen (11%), continuous positive airway pressure (51.4%), high-flow nasal cannula (14.5%), mechanical ventilation (23.1%), nebulization (74%), antibiotics (35.9%), and vasoactive drugs (13.9%). The mortality was 8.1%. Underlying comorbidity, chest retractions, respiratory failure at admission, presence of shock, and need for mechanical ventilation were independent predictors of PICU admission. Isolation of virus or coinfection was not associated with disease severity, intensive care needs, and outcomes. Conclusion: Among infants with AVB, RSV and rhinovirus were predominant. One-third infants with AVB needed PICU admission. The presence of comorbidity, chest retractions, respiratory failure, shock, and need for mechanical ventilation independently predicted PICU admission.

Research paper thumbnail of Clinical Profile, Hospital Course and Outcome of Children with COVID-19

Indian Journal of Pediatrics, 2021

Objectives To describe the epidemiological and clinical characteristics and outcome of hospitaliz... more Objectives To describe the epidemiological and clinical characteristics and outcome of hospitalized children with COVID-19 during the initial phase of the pandemic. Methods This was a cross-sectional descriptive study conducted at the dedicated COVID-19 hospital of a tertiary care referral center in North India. Consecutive children aged 14 y or younger who tested positive for SARS-CoV-2 by RT-PCR from nasopharyngeal swab between 1 April 2020 and 15 July 2020 were included. Results Of 31 children with median (IQR) age of 33 (9-96) mo, 9 (29%) were infants. About 74% (n = 23) had history of household contact. Comorbidities were noted in 6 (19%) children. More than half (58%) were asymptomatic. Of 13 symptomatic children, median (IQR) duration of symptoms was 2 (1-5.5) d. Fever (32%) was most common followed by cough (19%), rapid breathing (13%), diarrhea (10%) and vomiting (10%). Severe [n = 4, 13%] and critical [n = 1, 3%] illnesses were noted more commonly in infants with comorbidities. Three (10%) children required PICU admission and invasive ventilation; one died. Median (IQR) length of hospital stay was 15 (11-20) d. Follow up RT-PCR before discharge was performed in 17 children and the median (IQR) duration to RT-PCR negativity was 16 (12-19) d. Conclusions In the early pandemic, most children with COVID-19 had a household contact and presented with asymptomatic or mild illness. Severe and critical illness were observed in young infants and those with comorbidities.

Research paper thumbnail of Multi-Organ Involvement in COVID-19: Beyond Pulmonary Manifestations

Journal of Clinical Medicine, 2021

Coronavirus Disease 19 (COVID-19), due to severe acute respiratory syndrome coronavirus-2 (SARS-C... more Coronavirus Disease 19 (COVID-19), due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has become an on-going global health emergency affecting over 94 million cases with more than 2 million deaths globally. Primarily identified as atypical pneumonia, it has developed into severe acute respiratory distress syndrome (ARDS), a multi-organ dysfunction with associated fatality. Ever since its emergence, COVID-19 with its plethora of clinical presentations has signalled its dynamic nature and versatility of the disease process. Being a disease with droplet transmission has now assumed the proportion of a suspected airborne nature which, once proved, poses a Herculean task to control. Because of the wide distribution of the human angiotensin-converting enzyme-2 (hACE2) receptors, known for its transmission, we envisage its multiorgan spread and extensive disease distribution. Thus, an extensive review of the extrapulmonary organotropism of SARS-CoV-2 with organ-specific pa...

Research paper thumbnail of Pathological Involvement of Cardiovascular System in COVID-19: A Systematic Review

Research paper thumbnail of Persistence of SARS-COV-2 in body fluids: a bystander or whistle blower

Iranian Journal of Microbiology, 2020

The novel Coronavirus COVID-19 is wrecking a havoc across the globe and has been declared as a pa... more The novel Coronavirus COVID-19 is wrecking a havoc across the globe and has been declared as a pandemic by WHO. Apart from transmission and shedding of the virus through respiratory secretions in the form of droplets (mainly), several studies have shown the presence of the virus in various samples such as stool, urine and occasionally in blood, semen, tears and breastmilk. Whereas government authority guidelines consider a person as cured from COVID-19 when along with clinical improvement no more virus can be detected primarily on respiratory samples along with clinical improvement; the persistence of the virus in these body fluids even after clinical recovery and negative RT-PCR test results on respiratory samples, has raised many questions about the elusive nature of this novel virus along with the possibility of other routes of transmission of this virus in the community. Although studies performed till now across the globe on persistence of SARSCOV-2 in various body fluids are s...

Research paper thumbnail of Viral Hepatitis E and Chronicity: A Growing Public Health Concern

Frontiers in Microbiology, 2020

Hepatitis E viral infection recently emerges as a global health concern. Over the last decade, th... more Hepatitis E viral infection recently emerges as a global health concern. Over the last decade, the understanding of hepatitis E virus (HEV) had changed with the discovery of new genotypes like genotype-7 and genotype-8 with associated host and mode of infection. Diversification in the mode of hepatitis E infection transmission through blood transfusion, and organ transplants in contrast to classical feco-oral and zoonotic mode is the recent medical concern. The wide spectrum of infection ranging from selflimiting to acute liver failure is now overpowered by HEV genotype-specific chronic infection especially in transplant patients. This concern is further escalated by the extrahepatic manifestations of HEV targeting the central nervous system (CNS), kidney, heart, and pancreas. However, with the development of advanced efficient cell culture systems and animal models simulating the infection, much clarity toward understanding the pathogenetic mechanism of HEV has been developed. Also this facilitates the development of vaccines research or therapeutics. In this review, we highlight all the novel findings in every aspect of HEV with special emphasis on recently emerging chronic mode of infection with specific diagnosis and treatment regime with an optimistic hope to help virologists and/or liver specialists working in the field of viral hepatitis.

Research paper thumbnail of Antimicrobial Activity of Aristolochia tagala Cham. Centella asiatica Linn. Houttuynia cordata Thunb. on Multi- drug Resistant Clinical Isolates

International Journal of Pharmaceutical Sciences Review and Research, 2020

The objective of this study is to evaluation of antimicrobial activity of Aristolochia tagala Cha... more The objective of this study is to evaluation of antimicrobial activity of Aristolochia tagala Cham. (AT), Centella asiatica Linn. (CA), Houttuynia cordata Thunb (HC) on multi-drug resistant bacteria isolated from clinical samples. Alcoholic extracts of these plants carried out by adopting Kirby-Bauer disc diffusion method against standard strains (ATCC) and resistant clinical isolates of Staphyllococcus aureus, Enterococcus faecalis and Staphyllococcus aureus. Piperacillin, ampicillin, amikacin, ciprofloxacin, and cefotaxime served as positive controls in the standard test and nitrofurantoin, teicoplanin, linezolid, and vancomycin were used in the testing of the resistant isolates. 100 mg/mL of the plant extracts were used as the test extracts taking 2.5 % DMSO as a negative control. From the zone of inhibition (mm) recorded, AT demonstrated higher antimicrobial efficacy against Enterococcus and S. aureus. Another significant finding is HC showed considerable effectiveness against E.Coli. However, methanolic extract of CA showed only moderate antimicrobial activity. Good antibacterial activity was seen with AT alcoholic extracts for Enterococcus and S. aureus resistant strains in clinical isolates. Antibacterial activity of HC against E. coli isolates also holds promising results.

Research paper thumbnail of An anatomical model for SARS-CoV-2 entry into mastoid and middle ear in COVID-19 patients

Recently Frazier et al detected SARS-CoV-2 virus in autopsy samples from middle ear and mastoid o... more Recently Frazier et al detected SARS-CoV-2 virus in autopsy samples from middle ear and mastoid of COVID-19 deceased. Our article presents an anatomical model for the possible route by which SARS-CoV-2 may pass into the middle ear cavity and hence to the mastoid cavity. The anatomic correlation explained in this article will not only help in explaining the pathological basis of the findings presented by Frazier et al but will also imply for the precautionary measures to be taken while dealing with COVID-19 patients with otolaryngeal problems.